The Division of Health Services Research and Policy (HSR) in the Department of Community and Preventive Medicine (CPM) at the University of Rochester (UR) is seeking continuation of its highly successful AHRQ/NRSA-supported predoctoral HSR training program and re-establishment of a postdoctoral program funded by AHRQ/NRSA from 1992 to 2004. The broad, long-term objectives of this application are to train fellows to develop the knowledge, skills, and experience needed to become successful health services researchers. The rationale for the program is the need for an interdisciplinary, highly trained, and diverse HSR workforce to conduct research for healthcare policymakers, administrators, and providers that will improve healthcare access, quality, outcomes, and services use and costs. This application capitalizes on several outstanding UR programs: 5 nationally renowned clinical departments with strong HSR components (Family Medicine, Geriatrics, Neurology, Pediatrics, and Psychiatry), the NIH-funded Clinical and Translational Science Institute, and the UR's unique Center for Community Health. Seven outside partners, including health insurers, are included. The 7 predoctoral and 4 postdoctoral specific aims include rigorous HSR coursework, learning HSR skillsets through targeted workshops and experiences, and intensive research experience, all within a state-of-the-art mentoring program. The predoctoral program will be broad, addressing all 8 AHRQ Special Research Training Objectives, with special concentrations in translating research into practice and policy (TRIPP);patient quality;and payments, markets, and organization. The postdoctoral program will focus on TRIPP, quality improvement, and health care disparities. Support is requested for 5 predoctoral slots, each of which will cover 5 years (as is done now), and to admit 7 postdoctoral fellows, generally for 3 years: 2 in Year 1, 1 each in Years 2 and 3, 2 in Year 4, and 1 in Year 5. For budgetary purposes we assume we will admit 5 MDs (PGY4 at entry) and 2 PhDs (PGYO), but we could admit any combination. The proposed training program is relevant to public health because it will help AHRQ to achieve its mission: "to improve the quality, safety, efficiency, and effectiveness of healthcare for all Americans." By focusing on Healthy People 2010 content areas and AHRQ Training Objectives, our training programs will help prepare the needed HSR workforce to study and solve critical national healthcare needs.